Until the 1940s, there were few treatments of any kind for tinea pedis (athlete's foot). Spurred by the prevalence of dermatophytoses among military personnel during the wars of the mid-twentieth century, the search for truly effective treatments began. Azole antifungals were first synthesized in the late 1960s, and over the next two decades, research and development focused on this class of treatments, representing a major breakthrough in the targeted treatment of fungal infections. Further progress was made with the development of potent fungicidal allylamines in the 1990s. Today, one such allylamine, terbinafine, remains the most potent treatment for tinea infections. Terbinafine is the most effective topical agent against tinea pedis (Crawford & Hollis, Cochrane Database of Systematic Reviews 2007, Issue 3. Art. No.: CD001434). Unlike fungistats, which require up to four weeks of application, terbinafine is effective in a shorter course of treatment. Current labeling guidelines for terbinafine cream call for twice-daily application for 1-2 weeks (Lamisil AT® Drug Facts, GlaxoSmithKline Consumer Healthcare Holdings, 2017).
By comparison, antiperspirant treatment for tinea pedis has received relatively little academic attention. The only notable example of an antiperspirant treatment for tinea pedis comes from a 1975 study by Leyden & Kligman (Arch Dermatol, Vol. 111, p. 1004, August, 1975). They found that a 30% aluminum chloride solution was effective at reducing unpleasant symptoms of tinea pedis. However, this treatment did not resolve the infection entirely; instead, it transformed the macerated, malodorous form of tinea pedis associated with bacterial co-infection (sometimes called dermatophytosis complex) back into the dry, scaly type that indicates a purely fungal infection (dermatophytosis simplex). Because of the focus on the development of antifungals that promised to treat the underlying cause of tinea pedis, there has been little further research on the use of antiperspirants in the treatment of tinea pedis. In 2001, Koca et al. (O.M.Ü. Tip Dergisi Cilt: 18 No. 3, p. 192, 2001) conducted a study on a combination antiperspirant-antifungal therapy. Patients were instructed to apply cream containing clotrimazole (a fungistatic azole antifungal) in the morning, and aluminum chlorohydrate cream in the evening. The researchers found no benefit from the addition of an antiperspirant compared to antifungal therapy alone.
Dees (U.S. Pat. No. 7,201,914) describes combining an antiperspirant with an antimicrobial for the treatment of acne. Dees does not describe any standard topical antifungal agents as examples of antimicrobial agents. Lester (U.S. Pat. Publication No. 2010/0056430) describes reducing foot odor using antibacterials with other ingredients such as terbinafine and aluminum chloride, but Lester did not combine his materials with an alcohol drying agent or use them in combination for treatment of infections such as dermatophytosis. Villalobos (U.S. Pat. Publication 2012/0061267) describes using a terbinafine wipe with alcohol. Villalobos does not use an antibacterial or an antiperspirant compound and failed to demonstrate efficacy.
What is needed is an effective therapy that can be applied for the efficient treatment of dermatophytic infections irrespective of the stage of the infection.